Outcome of vitrectomy with intravitreal injection of triamcinolone for idiopathic macular epiretinal membrane

Objective

To study the outcome of intravitreal injection of triamcinolone acetonide (IVTA) as an adjuvant in vitrectomy for idiopathic epiretinal membranes (iERM).

Methods

A randomized controlled trial was designed.Forty-nine eyes of 49 patients with iERM were included in Beijing Tongren Hospital from September 2013 to June 2014.The patients were randomized into a vitrectomy group (25 eyes) and a vitrectomy combined with IVTA group (24 eyes), and IVTA 2 mg was performed during vitrectomy in the vitrectomy combined with IVTA group.Best corrected visual acuity (BCVA, LogMAR) was examined before and after surgery.Intraocular pressure was measured to evaluate the safety of the surgeries.Optical coherence tomography (OCT) were employed to assess the central macular thickness (CMT) and macular volume.The differential values between postoperative 1 month, 3 months, 12 months were calculated to quantify the variable quantity of BCVA, CMT and macular volume.The study protocol was approved by an Ethics Committee of Beijing Tongren Hospital.This study complied with the Declaration of Helsinki.

Results

BCVA in postoperative 1 month and 12 months was better than that in preoperation in the vitrectomy combined with IVTA group (all at P<0.05). In post operative 1 month and 12 months, CMT was (432.46±66.68) μm and (378.38±42.31) μm in the vitrectomy with IVTA group or (433.20±52.71) μm and (383.00±47.58) μm in the vitrectomy group, which was less than (487.58±93.84) and (517.64±92.05) μm in preoperation (all at P<0.05). In post operative 1 month and 12 months, macular volume was (11.68±1.11) mm³ and (10.68±0.91) mm³ in the vitrectomy with IVTA group or (11.66±0.66) mm³, (10.36±0.57) mm³ in the vitrectomy group, which was less than (12.86±2.24) mm³and (13.06±1.42) mm³ in the preoperation (all at P<0.05). The differential values of BCVA, CMT and macular volume in postoperative 1 month, 3 and 12 months from preoperation were not significantly different (all at P>0.05). Postoperative intraocular pressure increased in 3 eyes (12.5%) in the vetrectomy with IVTA group and returned to normal following local application of hypotensive drugs.

Conclusions

Vitrectomy combined with IVTA is a safe and an effective procedure for iERM by improving BCVA and CMT.However, IVTA during vitrectomy dose not significantly promote the recovery of macular function in comparison with only vitrectomy.